Need help with labs, high everything!

Hey everyone! So Im on HCG mono, 800iu every other day, 10mg tamoxifen twice per day. Doctor suggested due to recent labs I drop to 500iu eod and add 1/2 mg of anastrozole twice per week. Sometimes I feel like we are just guessing with what to do with me. I have a lot of anxiety and not much improvement with my symptons prior to HCG. Been on for over a year and really have just been backing the dose down every several months because my test was too high, then estradiol was too high. Then I was on way too much anastrozole so we took me off that completely(now adding a conservative dose). Honestly its been a mess. I am going to see another doctor this month to get a second opinion. Anyway my doctor is suggesting I donate blood or get a therapeutic phlebotomy because of my elevated hemoglobin and hematocrit. Anyone have any thoughts? I contacted my primary doctor and they said with slightly elevated levels they dont do phlebotomy and that they would only do it if your confirmed to have Polycythemia vera. I sent her my blood work so I will see what she says back. Looks like I cant upload from my work computer. I can upload my labs later. For now

Total test was 1208(range 348-1197ng/dl)
Free T 25.5(range 8.7-25.1pg/ml)
estradiol 88.3 (not sensitive, range 7.6-42.6pg/ml)
hemoglobin 17.9 (range 12.6-17.7 g/dl)
hematocrit 52.5 (37.5-51.0%)

Your Testosterone serum levels look great!

You need to lower your Estrogen levels and a very small dose of an AI like .25 mg twice weekly will do that for you without crashing you.

Give blood and hematocrit will come down.

Honestly, you need some tweaking to be honest.

I would like to see SHBG, Prolactin and PSA in addition to a full Thyroid work up as well.

Thanks, I'll see what I can do about getting the rest of those labs. I checked with my primary doctor about my hematocrit, she wasnt particularly concerned about it. She wants to check a few other thing but said they only do phlebotomy for Polycythemia vera and something else about iron and liver values. Id have to check exactly what she said. Anyway I'm getting more labs on Thursday.

Honestly, I don't get the 2x Tamox protocol, unless you're seeing increased receptor sensitivity in the nipple region. Even then, it should be a short-term program til estrogen levels stabilize, or unless it was included in a PCT/Restart program with the HPTA, which it still is a minimum timeline program.

Since your serum level is all driven by LH, via HCG, good chance that some (or a lot) of the E2 elevation is produced intratesticular. If so, it's virtually uncontrollable with an inhibitor like Arimidex. On that subject, as stressed to other members, you NEED the sensitive or ultra-sensitive assay. I know it looks off the charts with your provided lab, but the sen/Ul-Sen measurement accuracy is on a whole different level than the others that are used for the ladies. Without it, I truly can't see how anyone can "effectively" manage their E2 situation, but that's just MHO, as it is with many HRT physicians that are in the know.

On a Free Test/SHBG calculator, your SHBG is looking somewhere in the mid 40's +/- a few points. Albumin is also a factor with some minimal contribution to the matter. Your Free Test is at 2.1%, which again, MHO, 2% to 3% is an ideal range. You "could" possibly increase this percentage a bit with increasing vitamin D3 (if needed), maybe some nettle, etc., which in turn could allow you to reduce total serum to achieve ultimately the same results. You can adjust this around to see what fits you, but 15ng/dl to 20ng/dl on Free Test "usually" seems to be a good place to sustain long-term benefits, permitting other variables like thyroid, adrenals, pregenolone, and other pathways, vitamins, minerals, etc., are in order.

Conclusion ... Yeah, I don't really agree with how your current physician is handling your program. I think he's focused on one (1) department, and he's doing a lot of guesswork on where to go next. Sounds like HRT is your future, why not just get on a little cyp, a little HCG, and other hormones and/or inhibitors "as needed". Again, this Tamox thing has me a little puzzled, maybe you can clarify? Thanks

Thanks for the reply, the tamoxifen protocol I don't really understand fully either. It was a preventative thing initially because HCG generally causes estrogen to rise more than trt. My doctor has kept me on it though for the whole time now. Im going to talk about dropping it if we finally get my estradiol into a good place with the adex. I know everyone suggests the sensitive assay, I asked my doctor and she replied that she has never had a problem with the regular test. It seems at times that my doctor is just waiting for symptoms to arise and then reacting to them. Not really knowing what a proper protocol should be for HCG mono but then again Im sure everyone is different and reacting to symptoms is what doctors do at times.

When I first started my dose was 2500 iu's every other day, my test was through the roof at greater than 1500. It took several months of backing down slowly to get it to a good range but that didn't last long because my estrogen quickly rose. Im really hoping this new doctor is up on his stuff. I would consider Defy but honestly Ive been getting my HCG for just a 10 dollar copay for a month supply. A lot of people have had it denied by their insurance but Ive managed to get it through. That also scares me about switching doctors, that some how they will stop covering the hcg. I didnt want to start TRT because Im looking to have another kid soon so I figured I could stick with mono for now. My doctor now, whos real specialty is fertility did not suggest switching until after I get my wife preggo again. She didnt deny that trt with hcg could keep me fertile but she just said why chance it right now if we can get you comfortable on mono.

Wow I just realized Im replying with two different usernames. Sorry about that everyone, I forgot I had created the old JSmitty one. Maybe I can delete one of these profiles?

I'm also on HCG mono and going through a lot that you have for the last 8 months, it's a mess is an understatement. Anxiety through the roof, everything is high just like you and I've been going to a well known doctor. This HRT stuff is like the proverbial dog chasing his tail, at least this has been my experience and from what I've read on countless other threads from other people trying to "dial themselves in."

Whats your dose like and are you on arimidex? My dose was just changed about 3 weeks ago to 500iu eod of hcg and 1/2 mg of arimidex twice per week. I feel like the anxiety is subsiding finally and my mood is improving. Another 3 weeks or so until I get labs done again.

Gene, could you delete my other profile and all comments or messages associated with it? JS....Fitness....Or direct me on how to do that myself. I never realized that when people search for my business that my posts to this forum would pop up and I'd prefer to keep this more private. Also is there anyway to change my username that Im using now?

go to a anti aging clinic primary doctors suck on trt